US v Elizabethtown Hematology
The government accused the practice of false billings by increasing infusion times and manipulating treatment protocols. The feds say the practice used -25 codes when it was not warranted. The practice and its owners Drs. Yusuf Deshmukh and Rafiq Ur Rahman deny any wrongdoing and the feds state they "violated the laws and the patient trust". This was a whistleblower case and Dr. Ijaz Mahmood will get over $200,000 of the $3.732 million the practice will pay.
US v Kibert
Dr. Leonard Kibert of Houston and four others were arrested and charged with Medicare fraud in relation to the New Life Sleeping and Disorder Center. The charge was doing unnecessary tests and billing for tests never done. There are also charges of money laundering and kickbacks.
US v Glazer
Dr. Robert Glazer of Los Angeles was indicted for healthcare fraud for writing prescriptions for DME that was not needed. He sold the prescriptions to others who sold them to DME suppliers. This caused Medicare to pay out millions of dollars of money for unneeded DME supplies.
Macias v Pacific Health
In a whistleblower suit, a former nurse who was terminated from the hospital, has accused the corporation of the now closed hospital of fraudulently billing feds for kickback schemes. The suit claims that the company conspired to keep their psychiatric beds full since they pay well. The feds have not yet intervened.
US v Hope
Schella Hope of Georgia was sentenced to 16 years in prison for health fraud, money laundering and identity theft. She stole the identity of children in Head Start and used their information to bill the feds for items never furnished. She used the $4 million for cars, clothes and vacations.
US v Shands Health System
Shands agreed to pay $3.25 million to the government to settle a whistleblower suit for improper patient admissions.
US v Ohia
Ahaoma Ohia of Missouri City, Texas, was found guilty by a jury of wire fraud. He billed for DME for patients and then gave the patients DME of lesser value than what was billed or none at all. He faces 140 years in prison.
US v Jafari
Dr. Maryam Jafari, of New Jersey, was sentenced to 21 months in prison, fined $45000 and forfeited $40,261 for her receiving kickbacks from the Orange MRI. She took money for referring patients for testing. She was caught accepting an envelope with $1965 for three months of referrals. Top
US v Omidi
In two separate actions against the family that owned 1-800 GET- THIN in southern California the FBI raided the offices of the two Omidi brothers. The feds did this under a sealed warrant and would not comment. Cindy Omidi, the mother of the family, was arrested for structuring financial transactions to avoid reporting requirements. She allegedly purchased over two dozen money orders for $2900 just below the $3000 reporting requirement. Both Omidi brothers are physicians but one lost his license for failing to disclose attending a school in which he was expelled after being arrested in a burglary. The other brother had his license put on probation for three years in a settlement on the charge of performing surgeries at an unaccredited facility. Top
Ervine v Desert View Regional Med
In I can't believe there are people who still do not know the law or are idiots, the hospital and a physician's office in Nevada both refused to provide ASL interpreters for two deaf individuals. They were rightly sued for state and federal claims. The court didn't comment on the state claims of emotional distress but allowed the claim to continue on a Rehabilitation claim. They said the statute of limitations did not run since the acts were repeated and each one is a new claim. The ADA claim was barred since there could be no damages only an injunction. There was no imminent threat that required an injunction. Top
Hamilton v Sheridan Healthcorp.
Another physician who was disciplined for poor performance cried racial discrimination. They lost. They could show no similar situated individual treated differently.
Nyack v St. Vincent's Hospital
This is an OB resident who was let go and sued for race and gender. She lost part and won part. The part she won was due to a supervisor writing the resident was fired due to significant concerns about her medical progress and a medically complicated pregnancy. There were no racial discriminatory issues.
Valent v Hackettstown Hosp.
In an interesting case a nurse was fired from the hospital for refusing to have a flu shot. She was then denied unemployment benefits and she sued. She won since the hospital's allowance of refusing on medical or religious beliefs were discriminatory to one who just refused.
Wayne County Hosp. v Jacokson
A patient sued in Kentucky state court the hospital for a misread x-ray and won. The hospital sued the radiologist for indemnification. In the district court the case was bifurcated into liability and damages. The radiologist won the liability issue and the hospital appealed. Since Jacokson was not in privity with the hospital the underlying issues could be tried again. Therefore the district trial where the hospital lost is confirmed. IF A HOSPITAL SUES A PHYSICIAN FOR INDEMNITY IN A MED MAL CASE ONE SHOULD THINK TWICE ABOUT WORKING AT THE HOSPITAL.
Weidner-Jordan v Lewis Clark
The former CEO of the hospital lost her job for complaining about harassment from a surgeon. This is one of several suits regarding Dr. Allen Sossan. the others are med mal suits. The current suit alleges Dr. Sossan did unnecessary surgery so the physicians that own the hospital could benefit. Dr. Sossan does spine surgery. The med mal suits have the same complaints. Sossan lost his privileges at Lewis Clark after he lost his privileges at Avera Hospital. The physician board members are alleged to blame Weidner-Jordan for the loss of Sossan and the drastic decrease in the hospital revenue after he left.
Robinson v University Hospital
Dr. Lamar Robinson and Dr. Jasbir Ahluwalia sued the hospital had their privileges revoked after anti abortion protesters starting targeting the hospital. The two physician do abortions. The settlement said the hospital was restrained from revoking the admitting privileges because of the physicians willingness to do abortions at another facility. The physicians can now restart doing abortions within 30 miles of the hospital. This is the rule passed by the Texas legislature.
Pacific Radiation Oncology v
The plaintiffs have sued the hospital for its keeping them off the staff to treat patients with radiation therapy because they were not employed. The hospital had answered the complaint with a counter claim for breach of contract. The contract relied on by the hospital is the medical staff bylaws which has a clause forbidding the physicians from suing the hospital. In this case the court has refused to dismiss the counter claim. They did not decide on the merits only whether the case could go forward. They did not decide whether or not the bylaws was a contract under Hawaii law.
Semertzides v Bethesda health
In yet another case of either poor lawyering or a physician with no insight the doctor was removed from the hospital after the usual hearings. He sued for antitrust and forgot to define the geographic area. The case was lost in summary judgment. No one cares whether the physician thinks he was taken off the staff by competitors if you can not prove the area. Once you attempt to prove the area you usually automatically lose. Top
An unidentified woman filed a lawsuit against the medical center and an employee for unlawfully obtaining her confidential medical information and releasing it to a former boyfriend. He posted the information stating she has syphilis.
Tabata v Charleston Area Med Ctr.
The lower court ruled that a class action was not appropriate for the breach of confidentiality in the hospital posting the medical information of 3600 patients on the web. The reason was no injury. The high court overruled the lower court and said that the class action was appropriate since there was commonaltity, typicality and predominance with all the plaintiffs as a class. The high court stressed they were not ruling on the merits of the case for breach of confidentiality and invasion of privacy.
Patients v Hershey Medical Center
The records of over 1600 patients at the hospital were compromised by a person entering information on his personal computer and then sending the information to two others.
Patients v Access Health CT
The Obamacare exchange had information compromised. They found this out by the information of about 400 individuals was in a backpack along with exchange information.
Patients v St. Joseph Health
A thumb drive from an unlocked employee locker was stolen in Santa Rosa, California, with medical information on 34,000 patients. Another example of poor or non existent teaching regarding confidentiality and something that would never have happened without EMR. Top
Kasem v Kasem
The DJ Casey Kasem is the center of a fight between his wife and his children. The court initially ordered Kasem to get sustenance and after hearing the case has decided that the daughters have conserveratorship and that all food and water may be withheld. He currently resides in a hospice in Washington. The wife wanted sustenance to continue despite Kasem's directive to withhold it. Kasey died several days after the ruling. Top
Lawrey v Good Samaritan Hosp.
In a case of the attorney does not get the law or the medicine he sued on behalf of a newborn with Erb's Palsy. The plaintiff's expert didn't explain how the physician was at fault if the injury was caused with the head and shoulder still in the birth canal. The expert did not explain how in a vaginal delivery it is lack of informed consent not to tell the mother about the possibility of shoulder dystocia routinely. What is there to appeal? What is there to discern med mal initially? Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.